Nutrition Policies Can Address Inequalities

The analysis of Americans' diets shows just how important the campaign against trans fat has been to the public's health -- especially that of low-income Americans -- and why FDA needs to bring it home.

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Recent news coverage of a major analysis of Americans' diets over the past decade properly focused on the widening gap in healthy eating between higher-income and lower-income populations in our country. A typical headline reported: "U.S. diet improves slightly, but gap widens between rich and poor."

That trend has been obvious for some time, and is one of the reasons that Food Day 2014, sponsored by my organization, the Center for Science in the Public Interest (CSPI), will focus this year on food justice: taking a hard look at issues of food access and justice for food and farm workers.

More importantly, however, the study told a story about the critical role federal nutrition policies, often spurred on by state and local action, can have on the health of our country, especially vulnerable populations.

"The reduction in trans fat consumption contributed more than half of the improvement in the overall AHEI [Alternative Healthy Eating Index] 2010," the study authors wrote. They also wrote that ". . . reductions in trans fat have likely benefited low-SES [socioeconomic status] groups as much as higher-SES groups because the major source was inexpensive processed and fast foods that are more commonly consumed by low-income consumers."

How did that happen?

The elimination of artificial trans fat, has been a hard-fought public health campaign. Abundant in many foods such as cookies and margarine and in restaurants' deep-fat fryers, artificial trans fat was estimated to be causing as many as 50,000 fatal heart attacks a year.

Initially the food industry resisted calls from public health advocates to eliminate artificial trans fat, and action by the Food and Drug Administration was a long time coming. In 2003, the FDA required that trans fat content be disclosed on the Nutrition Facts panel beginning in January 2006. That prompted many companies to reformulate their products.

At about the same time, local and state public health agencies took action beyond just labeling. In 2007 New York City and Philadelphia passed laws largely eliminating the use of trans fat in restaurants, and that wave has swept across the country with large and small jurisdictions prohibiting their use in restaurants and bakeries. Adding further fuel to the fire, a California attorney, Steve Joseph, and CSPI sued the likes of McDonald's, Kraft, and KFC for using or failing to disclose the presence of trans fat.

The food industry's reformulations have eliminated roughly three-fourths of the trans fat in the food supply. That has saved tens of thousands of lives.

Late last year, the FDA finally took the bull by the horns and issued a proposal to ban artificial trans fat. That would save additional thousands of lives annually. While local and state public health agencies voiced their support for that proposal and many in the food industry have already eliminated their use, there are still naysayers, such as the Grocery Manufacturers Association (GMA) which claimed in its comments on the FDA proposal that its analysis of trans fat research "suggests intake of low levels of trans fat has no adverse effect on cardiovascular health."

In fact, researchers whose work GMA cited issued a stinging rebuke recently, writing to the FDA: "The GMA letter contains many other incorrect and misconceptions that are too numerous to address in this letter... As numerous previous reviews have concluded, trans fat intake should be as low as possible, which clearly supports the conclusion that trans fatty acids are NOT generally regarded as safe."

Now, this analysis of Americans' diets shows just how important the campaign against trans fat has been to the public's health -- especially that of low-income Americans -- and why FDA needs to bring it home.

The larger lesson, of course, is the vital importance of diet in the health of all Americans, and why nutrition policies -- from eliminating trans fat to reducing sodium in the food supply to curbing consumption of sugar drinks -- matter and how they can address the inequalities in our society.